Provider Demographics
NPI:1659995108
Name:MURTHY, KRISTIN LYNN (OTR)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LYNN
Last Name:MURTHY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13304 CANTERBURY DR
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-2600
Mailing Address - Country:US
Mailing Address - Phone:301-730-7773
Mailing Address - Fax:
Practice Address - Street 1:13214 FOUNTAIN HEAD PLZ
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-2678
Practice Address - Country:US
Practice Address - Phone:301-766-9293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08974225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOC008895OtherHAVE WORK PREVIOUSLY IN OH, WV, AND PA AS AN OCCUPATIONAL THERAPIST